Thibodaux Regional Network Development Corporation
Podiatrist, Foot & Ankle Surgery in Thibodaux, LA. Organization (NPI-2).
NPI number1043836166
StatusActive
Last updated in NPPESJun 2, 2025
Details
- NPI
- 1043836166
- Entity type
- Organization (NPI-2)
- Legal business name
- Thibodaux Regional Network Development Corporation
- Organization subpart
- No
- Enumeration date
- Jun 24, 2020
- Certification date
- Jun 2, 2025
- Last updated
- Jun 2, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 213ES0103X | Podiatrist, Foot & Ankle Surgery | – | – | Yes |
| 261QP1100X | Clinic/Center, Podiatric | – | – |
Other names
- Thibodaux Regional Foot & Ankle Center (Doing Business As)
Practice location
290 Bowie RdThibodaux, LA 70301-6712
Phone 985-493-4990 · Fax 985-493-4991
Mailing address
Po Box 5478Thibodaux, LA 70302-5478
Phone 985-435-4831 · Fax 985-449-2585
Authorized official
Kim Legendre Boudreaux
Contract Manager
9854934907
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